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急性骨髓炎疗程及难治性病原菌治疗

2014-01-29 cmt 医学论坛网

急性骨髓炎疗程及难治性病原菌治疗
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在一项1960年完成的研究中发现开始治疗的时间延误，抗生素使用疗程小于3周是骨髓炎复发的危险因素，但其他相关研究则认为抗生素治疗周期大于3周并不会显著提高患者的获益水平。在英国完成的一项研究认为，氯洒西林使用5周可以治疗骨髓炎，并且在其后数十年成为标准治疗策略。 在作者完成的一项研究中发现，20天或30天疗程的克林霉素或第一代头孢菌素治疗MRSA，链球菌或肺炎球菌等骨髓炎，短疗程口服治疗

在一项1960年完成的研究中发现开始治疗的时间延误，抗生素使用疗程小于3周是骨髓炎复发的危险因素，但其他相关研究则认为抗生素治疗周期大于3周并不会显著提高患者的获益水平。在英国完成的一项研究认为，氯洒西林使用5周可以治疗骨髓炎，并且在其后数十年成为标准治疗策略。

在作者完成的一项研究中发现，20天或30天疗程的克林霉素或第一代头孢菌素治疗MRSA，链球菌或肺炎球菌等骨髓炎，短疗程口服治疗的住院周期短，副作用小，医疗花费更好;此外，细菌产生耐药性的可能性小。

美国感染疾病协会基于现有的临床实践证据推荐对所有患者采取个体化治疗，若患儿的急性骨髓炎由MRSA引起，则可以考虑最低4-6周的抗生素治疗方案。但需要指出的是，目前尚缺乏有力证据支持上述推荐措施。该治疗策略也可应用于合并严重并发症或者由沙门氏菌引发的骨髓炎患儿中。

某种特殊类型的MRSA可以引发病理性骨折，但这类骨折并不一定需要手术介入。和MSSA相比，MRSA更容易出现深静脉血栓，脓栓肺栓塞等相关并发症。对甲氧西林耐药的链球菌性骨髓炎并发症发生率更高，而对青霉素耐药的肺炎链球菌并发症发生率并不升高。

骨髓炎患者还存在比较特殊的情况，如患者为新生儿，免疫抑制，营养不良等，抗生素治疗时间可相应延长。


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    2014-12-21 gous

    #难治性病原菌#

    0

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    2014-04-19 zjshifan_98647317

    #病原菌#

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    2014-08-28 智智灵药

    #急性骨髓炎#

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    2014-01-31 宋威

    #骨髓炎#

    0

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    2014-01-31 一叶知秋

    #难治性#

    0

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